Apparatus for positioning patients in a precise and immobilized manner are often used in treating patients using radiation application therapies. In order to control the application of energy to specific localized areas of a patient; it is necessary to precisely position the patient and ensure that patient movement does not occur during the application of the therapy. Examples of patient positioning systems are provided in U.S. Pat. No. 5,806,116, which issued Sep. 15, 1998 to Oliver et al. and in U.S. Pat. No. 6,161,237, which issued Dec. 19, 2000 to Tang et al., the contents of each of which are incorporated herein in their entireties. These systems use a lock bar arrangement to attach an accessory, such as a facemask to the table surface to position and immobilize the patient. These references do not teach attachments specifically used for immobilizing a patient in a more comfortable position for treatment of the thorax or torso.
Some breast-boards for positioning and immobilizing a patient for treatment of the torso or thorax are currently available. Examples of some currently available breast-boards include Torsoboards available from Bionix. These boards include a post located at the top of the board, which is grasped by the patient. This grasping places the patient's arm out of the way to allow access to the breast area for treatment. Typically, the post is not adjustable and remains in a single position on the breast-board. A separate U-shaped support on a post may be provided for the upper arm of the patient.
Other available models, such as the MED-TEC MT200, MT250 and MT 350 products lack a grasping-post and instead include a second U-shaped support for the forearm or wrist of the patient. In such embodiments, both U-shaped supports are mounted atop poles, which may be inserted into the board. The position of the upper arm support may be selected by the insertion hole selected, or by the rotation of the support in the hole. The support post may include a plate, or base, through which the post protrudes. A peg-like retaining post may be located on the plate and a rotated position may be maintained by insertion of the peg-like retaining post into a selected retaining hole on the breast-board. Using such embodiments, it may be inconvenient to reposition the support with the patient already on the board. In other embodiments, the peg-like post and retaining holes are absent and a screw clamp is used to retain the support in a selected rotated position. By using a screw clamp, the exact position of the rotation may be difficult to duplicate for subsequent treatments, and the post must be manually held in the desired position as the clamp is tightened.
Of these currently available breast-boards, many are standalone units which are placed on top a standard treatment table. The patient is position with the buttocks on the base of the breast-board, while the upper body lines on the elevated portion. An enlarged “butt stop” located on the proximal end of the breast-board base sits behind the buttocks of the patient. The breast-board is held in position by the weight of the patient thereon. Since the weight of the patient is used to retain the breast-board in place, these boards are typically rigid and a compression of the patient's tissues typically occurs with the weight of the patient is placed thereon. As imaging of the treatment area typically occurs on an imaging table, such as a CT or MRI support table, which holds that patient in a different position than the treatment table, application of treatment radiation to the area must be designed to account for any difference in tissue compression and the change of angle caused by use of a standard breast-board. This can result in the application of treatment radiation to a larger area, than treatment of the specific area of concern may require.
Accordingly, it would be an improvement in the art to provide a breast-board that included supports for the patient's arms that may be used as either a post or as a cupping-support. It would be a further improvement to provide reproducible rotatable positioning for a support that did not use a screw clamp or require the removal and insertion of a peg-like post from the board, allowing additional comfort for a patient. An integrated adjustable support for the tilting of the board may constitute another improvement in the art. Such a breast-board system that is adapted for insertion into, or connection to, both a treatment table and a diagnostic imaging table, in order to provide more consistent imaging and treatment of a patient would be a further improvement in the art.